Care level 2
From care level 2 onwards, patients are classified as requiring heavy care. A nursing effort of at least three hours a day is required. Basic care activities should take up two thirds of the time, i.e. at least two hours daily, and should take place at three different times throughout the day.
Support in the household, which must be provided several times a week, is also one of the necessary criteria. Care level 2 is likely to be reached if the dementia disease is very advanced. At this point in time, there are usually additional secondary illnesses that further limit the condition due to the usually high age of the patients.
Complete immobility and full-time bedriddenness is not yet described. The described effort can also be achieved by instruction or by taking over various activities, even if the patient is physically fit and good on foot. With care level 2, the care allowance increases to almost double the amount of the previous level.
The rate has risen to 2015 as a result of the nursing care reform compared with previous years. If the nursing activities are taken over by relatives, a nursing allowance of 458 euros is paid. If the nursing activities are shifted to outside specialists, benefits in kind up to 1144 Euro can be paid.
Care level 3
Care level 3 is the highest level that can be assigned for nursing needs. The allocation is accompanied by an extremely bad condition of the patient and thus means a lot of work for the people caring for him. In addition to the severe dementia, which the patient has developed in the course of his or her basic illness, there are other mostly age-related illnesses, which would often make a nursing intervention necessary on their own.
Expressed in terms of time, nursing services must be required for at least five hours a day. Of these, four hours are allotted to basic care activities if care level 3 is to be approved. There must also be a need to be able to provide assistance around the clock.
If help is needed during the night between 10 p.m. and 6 a.m., for example when going to the toilet at night, these are counted as normal hours in the total. As the sole criterion for care level 3, it is not sufficient that help is also needed at night if no care services are required for at least five hours during the day. Since the third level represents the last, but the nursing effort can still be increased, a hardship provision has been put into effect.
This allows a further increase in payments by the insurance companies. The criteria for this are once again strictly defined. There are two possibilities: The minimum requirements of care level 3 must be clearly exceeded and also the night-time expenditure must exceed a person’s abilities, as may be the case with the mobilization or storage of severely overweight persons.
If there is no need for personnel with more than one head, but at least seven hours of nursing time are still needed to perform all tasks, the criteria for a hardship case are also met as long as two hours of nursing care are provided at night.Expressed in payments, relatives of patients with care level 3 receive 728 euros per month for self-care or 1612 euros for care-related benefits in kind. The latter sum can be increased to 1995 euros by a hardship case application and guarantee appropriate care.
